<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta name="viewport" content="width=device-width" />

<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
<title>Email Template</title>
	
<style type="text/css">
	@media screen and (max-width: 480px) {
		table {width: 100% !important;}
		.textbox {
			width:315px !important;
		}
	}
	
	@media screen and (max-width: 360px) {
		table {width: 100% !important;}
		.textbox {
			width:170px !important;
		}
	}
	
	@media screen and (max-width: 320px) {
		table {width: 100% !important;}
		.textbox {
			width:140px !important;
		}
	}
</style>

</head>
 
<body leftmargin="0" topmargin="0" marginwidth="0" marginheight="0">

<!-- BODY -->
<div align="center">
<table>
	<tr>
		<td></td>
		<td bgcolor="#FFFFFF">

			<div>
			<table style="width: 100%">
				<tr>
					<td>
						<h3>Hi, Bob</h3>
						<form action="http://ptpcpm.com/form-test.ashx" method="POST" name="PSForm2">
						<table>
							<tr>								
								<td>Name</td>
								<td><input class="textbox" id="Name" name="Name" type="text"></td>
							</tr>
							<tr>
								<td>Email</td>
								<td><input class="textbox" id="Email" name="Email" type="text" value="%%emailaddress%%"></td>
							</tr>
							<tr>
								<td>Telephone Number</td>
								<td><input class="textbox" id="TelephoneNumber" name="TelephoneNumber" type="text"></td>
							</tr>
							<tr>
								<td>&nbsp;</td>
								<td><input type="submit" value="Submit"></td>
							</tr>
						</table>
						</form>
						<!-- Callout Panel -->
						<p>
							Regards,<br/>
							PhuongTM
						</p><!-- /Callout Panel -->	
						
					</td>
				</tr>
			</table>
			</div><!-- /content -->
									
		</td>
		<td></td>
	</tr>
</table><!-- /BODY -->
</div>

</body>
</html>